Assessment of Small Airway Disease By Impulse Oscillometry In Relation to Asthma Control and Bronchial Hyperresponsiveness In Children

Abstract

Asthma is a heterogenous disease , usually characterized by chronic airway inflammation which affect whole respiratory tract ,from central to peripheral airway. Many children do not achieve sufficient asthma control in spite of the availability of efficient drugs. Lack of adherence to prescribed therapy is a major factor but peripheral airway dysfunction and inflammation could contribute to failed asthma control. This cross-sectional aimed to assess small airway function in asthmatic children and to correlate this to level of control , bronchial hyperresponsiveness (which assessed by spirometery and IOS pre- and post-bronchodilator and quality of life among them.

This study was conducted on 90 children ; 60 asthmatics with clinically definite asthma and Thirty healthy non asthmatic controls . Both asthmatics and controls were age and sex matched.

All studied cases were subjected to full history taking, complete clinical examination and anthropometric measurements. Assessment for effect of asthma on quality of life were done by spirometry and IOS (Resistance at 5 and 20 Hz, R5 and R20 respectively , R5-20 and AX were done pre- and post-bronchodilator.

Asthmatic patient were classified into asthamtics with small airway impairment (SAI) and those without small airway impairment (NSAI) according to MEF25/75 % impairement (<60% of predicted) and HRCT was done for selected patients of SAI patient group (n=10) to confirm evidence of small airway affection. *The current study revealed that :

• There was statistically insignificant difference between studied asthmatics and controls concerning age distribution; p>0.05.